Open Access Open Access  Restricted Access Subscription Access

Case Report:Laparoscopic Spleen Preserving Distal Pancreatectomy for Insulinoma


Affiliations
1 Prof. of Surgery, B. J. Medical College, Pune - 411001, India
 

We report a case of a 67-year-old male patient with an insulinoma of pancreas at the junction of body and tail. He underwent a laparoscopic spleen preserving distal pancreatectomy. Patient presented with episodes of giddiness and drowsiness for past 4 months. There was also history of tremor on exertion since 4 months. His symptoms improved with intake of food. During his episodes his blood sugar levels ranging from 35 mg%-50 mg%. Patient was thoroughly evaluated. USG abdomen and MRI abdomen showed normal study. His fasting serum insulin level raised with normal ACTH and cortisol level. DOTA PET Scan suggestive of focal octreotide receptor expressing lesion at the junction of body and tail of pancreas. There were no postoperative complications, and the patient was discharged from the hospital on day 6. The patient was ambulatory soon after the procedure. He was allowed to take oral liquids after 12 hrs post surgery, and his hospital stay was short; therefore, the surgery was judged to have been highly useful.
User
Notifications
Font Size

  • SoperNJ,BruntLM,DunneganDL,Meininger TA. Laparoscopic distal pancreatectomy in the porcine model. Surg Endosc 1994; 8: 57-60; discussion 60-1 [PMID: 8153866 DOI: 10.1007/BF02909495]
  • Gagner M, Pomp A, Herrera MF: Early experience with laparoscopic resections of islet cell tumors. Surgery 1996; 120: 1051―1054.
  • Gumbs AA, Gres P, Madureira F, Gayet B: Laparoscopic vs. open resection of pancreatic endocrine neoplasms: single institution’s experience over 14 years. Langenbecks Arch Surg 2008; 393: 391―395.
  • Kadam Diagnostic lab, Aundh, Pune lab report.
  • Baily & Love’s Short Practice of Surgery (26th Ed.) 52:788-795, 63:1055.
  • Sabiston textbook of Surgery (19th Ed.) 42:995-1008, 40: 951-960.
  • Schwartz’s Principle of Surgery (10th Ed.) 33:1391-1392.

Abstract Views: 144

PDF Views: 94




  • Case Report:Laparoscopic Spleen Preserving Distal Pancreatectomy for Insulinoma

Abstract Views: 144  |  PDF Views: 94

Authors

Gajanan R. Ekbote
Prof. of Surgery, B. J. Medical College, Pune - 411001, India
Shailesh Puntambekar
Prof. of Surgery, B. J. Medical College, Pune - 411001, India
Arvind Giram
Prof. of Surgery, B. J. Medical College, Pune - 411001, India
Ahsan Zuberi
Prof. of Surgery, B. J. Medical College, Pune - 411001, India

Abstract


We report a case of a 67-year-old male patient with an insulinoma of pancreas at the junction of body and tail. He underwent a laparoscopic spleen preserving distal pancreatectomy. Patient presented with episodes of giddiness and drowsiness for past 4 months. There was also history of tremor on exertion since 4 months. His symptoms improved with intake of food. During his episodes his blood sugar levels ranging from 35 mg%-50 mg%. Patient was thoroughly evaluated. USG abdomen and MRI abdomen showed normal study. His fasting serum insulin level raised with normal ACTH and cortisol level. DOTA PET Scan suggestive of focal octreotide receptor expressing lesion at the junction of body and tail of pancreas. There were no postoperative complications, and the patient was discharged from the hospital on day 6. The patient was ambulatory soon after the procedure. He was allowed to take oral liquids after 12 hrs post surgery, and his hospital stay was short; therefore, the surgery was judged to have been highly useful.

References